The Good, Bad and Ugly

The "good cop/bad cop" interrogation label has become a term of endearment thanks to thrill ride police movies like Lethal Weapon and Bad Boys. In fact, the movie-going public enjoys the split friend and foe personalities of fictional law enforcement characters so much, a film studio decided to invest a couple million dollars into a 2008 movie titled, Good Cop/Bad Cop.

Healthcare Auditors
Over the years, I've heard a similar label of "the good, bad and ugly," used to describe healthcare auditors' interviewing techniques and inspection outcomes.

Even though I am an auditor, I have had my share of inspections to undergo within my organization, too. So I fully understand "the good" and "the bad" references applied to auditors. But, I question "the ugly!"

The Good, the Bad and the Ugly title meant to depict auditors' tactics and inspections results originated from a 40-year old western movie.

The film's plot centers around three main characters, namely Clint Eastwood, "the good" who won every gunfight; "the bad" character who was a fair, but an impatient gunslinger who would shoot you at the blink of an eye if your responses to him were too vague, lengthy or just plain lies; and finally "the ugly" character who was a sheriff with a long list of his own crimes.

I've seen the good and bad, but thankfully to date, I have not witnessed the ugly sheriff auditor or seen serious adverse inspection outcome as a result of an ugly action.

Indulge me a bit longer and take a few minutes with me to reflect back on the activities and mental state that may have lead you to label an audit outcome as good or bad. Let's do this by paralleling the actions of the three cowboys.

The Good
As Eastwood "the good" was an excellent gunslinger, we can deduce his laboratory counterpart is one who passes every inspection with flying colors. There are small bits of stress, but prolonged anxiety coupled with chaos around him doesn't exist.

How did the good win every gunfight? The answer, focused preparation.

The first step in a focused preparation process is to clean the gun equipment (i.e., put standards of practice [SOP] documents in order).

I am convinced that, the good cowboy made sure that his gun was well polished and oiled. In our laboratory world, this would translate to our lab equipment being totally up to snuff and not held together with safety pins.

Next, his gun holster was strapped onto his hip at just the right height. This translates to everything in it proper place, at the proper time (i.e., specimens that should be cooled by refrigeration are not sitting at a hot workbench).

And finally, he most likely had an extra supply of extra bullets stored in his pocket before engaging in a gunfight (i.e., adequate lab supplies at hand).

The second preparatory step is called keeping our emotions in check. The good cowboy accomplished his relaxed approach by engaging in stress reduction and confidence building activities.

He most likely replayed in his mind countless times what the outcome of a successful gunfight would look like. Next, he probably rehearsed and practiced on his gun slinging technique, so that his actions were smooth as slicing butter with a hot knife.

And finally, he subjected himself to long horse rides through green meadows and by babbling waterfalls. These pleasurable excursions were excellent relaxation techniques and endorphin-boosting activities.

The Bad
Judging from the bad character's brutal and swift response to his victims, it was clear is that the victims were the ones who were not in control of their own actions. As a result, their inappropriate responses to his questions lead to dire outcomes.

The victims vague, lengthy responses and sometimes outright lying stemmed most likely from fear in not knowing what to say or do. The inept replies trigger unwanted consequences (i.e., low scores and an abundance of corrective actions).

We all know from experience that being unprepared and disorganized; failing to have dealt effectively with unresolved policy violations; or not addressing preventive and corrective notices in a timely manner can add up to very unpleasant audit experiences.  

50/50 Recipe for Success
Inspections contain both technical and humanistic characteristics to them. To be and receive the "the good" from your inspection event, let me suggest that you definitely prepare the external components well.

External components are the multiple pieces of hard evidence (i.e., SOPs, logs, equipment) that you show the auditor to support compliance requirements.

While the external piece is important, you also need to spend an equal amount of time on getting emotions in check with yourself, within your department and around your institution. It's been my experience that "good" outcomes are the result of a 50/50 preparation recipe.

Believe or not, many laboratorians getting ready for audits devalue the importance of investing a portion of their time on stress reduction. As a result, they perform poorly before the audit in the preparation stage, during the audit itself and after the inspection has concluded.

Yes, 50 percent of your auditing preperation time and drive should be invested in fine-tuning the emotionally charged energy that comes with the territory of inspections.

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